Código de Ética y Deontología de la Enfermería de la Comunidad

Yannis et al. (2011a) highlighted that analysis of past road safety patterns in developed

countries provides insight into the underlying process that relates the motorization level

with personal risk. This analysis is beneficial to predict the evolution of road safety in

developing countries which may have not yet reached the same breakpoints. According

to Oster and Strong (2013), public policies play an important role in reducing the overall

highway fatality rates. However, it is challenging to determine the effectiveness of a

particular policy in improving safety.

Lu (2007) highlighted that the annual number of fatalities in the Netherlands decreases

substantially by 7.2% during the period of implementation of Phase I of the Dutch road

infrastructure redesign programme (1998–2002). However, even though Phase II was not

implemented from 2002 to 2006, the annual number of fatalities decreases dramatically

by 23.9%. SWOV attempted to identify the explanatory factors which result in the abrupt

decrease of fatalities in 2004 – however, none of the explanations are convincing.

in road accidents exceeds the figures predicted according to a road safety programme.

Road safety is influenced by a variety of factors and therefore, it is not possible for a road

safety programme to address all of the issues concerning road safety. Hence, road safety

can only be controlled to a certain extent by the implementation of road safety

programmes. However, the effects of implementing a road safety programme on road

safety achievement are unclear.

2.7.1 Sustainable safety vision

Sustainable safety vision is an approach used to improve the road safety scenario in

the Netherlands in the last two decades. According to Wegman et al. (2008), there are

five core principles in sustainable safety vision, namely: (1) functionality of roads, (2)

homogeneity of masses and/or speed and direction, (3) predictability of road course and

road user behaviour by recognizable road designs, (4) forgivingness of both the

environment and road users, and (5) state of awareness by the road users. In order to

achieve sustainable safety vision, a large number of proposals are drafted which

encompass a wide range of road safety aspects such as infrastructure, vehicles, intelligent

transport systems, education, regulations and their enforcement, speed management,

driving while under the influence of alcohol and drugs, young and novice drivers, cyclists

and pedestrians, motorized two-wheelers, and heavy goods vehicles.

Mohan (2004) reviewed studies pertaining to road safety development. Some of the

key findings in this review are: automatic speed enforcement by means of speed cameras

seems to be effective in improving road safety, the use of helmets is the single most

effective safety measure available for motorcyclists since it reduces the probability of

injuries and fatalities, there is no clear evidence on the relationship between knowledge

the successful strategies are those which involve a combination of education and other

approaches such as legislations, regulations and eliminating the barriers that hinder the

implementation of road safety measures, the only effective way to encourage the use of

seat belts and child seats among motorists is the enforcement of laws which make their

use compulsory, education on pedestrian safety can improve childrens knowledge on road

safety and induce changes in road crossing behaviour.

Luoma and Sivak (2013) made the following recommendations in order to improve

the road safety scenario in the US in order to be at par with Sweden, the UK and the

Netherlands: (1) reduce the BAC limit to 0.5 g/l for all states and introduce effective

random breath testing, (2) re-examine the current speed limit policies and improve speed

enforcement, (3) implement primary seat-belt-wearing laws in each state that are

applicable to both front and rear seat occupants, and reward vehicle manufacturers for

installing advanced seat-belt reminders, (4) reconsider road safety targets to focus on

reducing fatalities rather than the rate of fatalities per distance driven, and (5) develop

new strategies to reduce the vehicle distance driven.

2.7.2 Road safety target

2.7.2.1 Setting road safety target

Elvik (2010a) highlighted that the road safety programmes implemented in Denmark,

Finland and Sweden do not produce the desired effect as initially hoped. Wittenberg et

al. (2013) concluded that the 50% reduction target set by the EU is too ambitious,

considering that the total number of people killed in road accidents in 2001 is 54,000.

Even though the number of road accident victims has decreased considerably, achieving

the maximum permitted limit of 27,000 deaths in 2010 is overoptimistic. Improving the

significantly to attain the collective objective of reducing the number of traffic road

fatalities by half. These include revising the speed limits, making amendments to the seat

belt laws, imposing stricter penalties for drunk driving, constructing safer roads, and

producing safer vehicles. More importantly, each Member State should identify which

measures are most effective in its country. Moreover, Lassarre (2001) claimed that

Europe’s road systems are capable of absorbing a 6% increase in traffic (vehicle-km) per annum while maintaining a constant number of fatalities.

Elvik (1993) examined the safety performance of Norwegian countries in which

quantified road safety targets were set, and the best performance was achieved by

countries with highly ambitious quantified targets. The more recent studies by Wong et

al. (2006) and Allsop et al. (2011) confirmed Elvik’s conclusion. According to Bener

(2009), the prevention of road traffic injuries in developing nations is inhibited by the

lack of knowledge, absence of reliable estimates on the current level of injuries, and

restrictive views on health and diseases. This situation occurs because studies that are

focused on reducing road traffic injuries are funded at a disproportionately lower level

compared to other health issues. In addition, the governments in developing countries do

not perceive road traffic injuries and fatalities as a public health problem.

2.7.2.2 Vision zero

According to Kanellaidis and Vardaki (2011), Vision Zero in Sweden,

Sustainable Safety Vision in the Netherlands, and Australia’s safe system are the main safe-system strategies in the world. They highlighted the role of road safety auditing to

improve road designs and develop a safety culture among road designers. Corben et al.

(2010) described the approach used in Western Australia (WA) in support of the ‘Towards Zero’ strategy. The ‘Safe System Matrix’ concept was created to identify the best mix of

initiatives for Western Australia’s next road safety strategy. The matrix consists of the following key areas: (1) safe roads and roadsides, (2) safe speeds, (3) safe vehicles, and

(4) safe road use.

Gaudry and Lapparent (2013b) highlighted the most interesting aspect of Annex

(ITFOCE/JTRC, 2008b: 439). The objective of reducing the death rate due to road traffic

accidents through the establishment of national targets is highlighted in this report. It shall

be noted that national targets are not forecasts – rather, they are extensions of the current

trends. Amazingly, it is observed that these targets are all linear with a decreasing trend,

except for three jurisdictions out of the 40 jurisdictions investigated. They also observed

a few trend breaks, which indicates that the national targets are achieved only if the trend

is downwards – literally, upward trends are non-existent. Gaudry and Lapparent (2013b)

also highlighted the following statement given in the official brochure of the Swedish

Road Administration: ‘Since the adoption of Zero Vision, the death toll on Swedish roads

has declined’. This implies that the objective of the Zero Vision has not progressed significantly since its adoption.